POCATELLO \u2013 When contract negotiations between Portneuf Health and Regence BlueShield of Idaho failed, allowing their existing agreement to expire earlier this week, thousands of east Idahoans were left holding the bag.<\/p>\n
Now those Regence policyholders are forced to choose whether to drive out of town for anything more than routine care, find a new insurance provider, or wait it out as the two parties continue negotiations. <\/p>\n
Many of those who no longer have in-network coverage at Portneuf health care facilities<\/a> are employees of the state of Idaho. In fact, a statement from Idaho\u2019s Office of Group Insurance says approximately 3,600 state employees on the state employee health plan have been impacted. <\/p>\n \u201cWe recognize that this situation is disruptive for all involved. OGI (the Office of Group Insurance) remains optimistic that this will get resolved,\u201d reads a communication sent out to affected people on Monday.<\/p>\n RELATED | Portneuf hospital, Regence split leaves patients out of network<\/a><\/p>\n Of these 3,600, about 1,800 are employees of Idaho State University in Pocatello. Lou Riepl, strategic communications manager for Regence, confirmed that this also includes employees of Pocatello-Chubbuck School District 25.<\/p>\n More broadly, Rieple said Regence estimates that approximately 5,700 people have been affected by the contract expiration.<\/p>\n The good news is that representatives from both Portneuf and Regence say that negotiations are ongoing.<\/p>\n \u201cWe are continuing to work toward an agreement that keeps care local and accessible for the communities we serve,\u201d reads a Monday news release from Portneuf Health.<\/p>\n Regence identifies the party it\u2019s been negotiating with as Ardent Health, Portneuf\u2019s Tennessee-based parent company.<\/p>\n \u201cWe understand the concern and trouble this causes our members, and we remain committed to continuing discussions with Ardent Health to bring Portneuf Medical Center\u2019s facilities and providers back in network,\u201d Regence states in its Monday release.<\/p>\n RELATED | Contract dispute between PMC and Regence insurance could raise members\u2019 health care costs<\/a><\/p>\n EastIdahoNews.com reached out to both Portneuf and Regence to learn more about the negotiation process. Regence replied with a written statement, and Nate Carter, CEO of Portneuf Health, sat down for an interview. <\/p>\n Here\u2019s what the two sides told us:<\/p>\n The negotiations <\/p>\n Regence said negotiations began late last year. \u201cRegence initiated negotiations in December 2025; we received our first proposal from Ardent Health in March 2026,\u201d Riepl said.<\/p>\n On Regence\u2019s side, negotiations are led by Regence BlueShield of Idaho\u2019s vice president of contracting and the director of provider contracting, who Riepl said are both based in Idaho.<\/p>\n Carter told EastIdahoNews that on Portneuf\u2019s side, negotiations have been led by him and John Abreu, CFO of Portneuf Health, with assistance from Ardent Health\u2019s contracting team. He also clarified that the executive team at Portneuf is also employed by Ardent Health.<\/p>\n The money dispute <\/p>\n Regence insures a significant portion of Portneuf\u2019s patients, with Carter saying it\u2019s around 12% to 15% of the hospital\u2019s total patient population. Carter also said Regence denies around 75% of Portneuf\u2019s claims, and then only pays around 78% of what it owes.<\/p>\n Because of this, Carter said that Regence currently owes Portneuf $25 million of unpaid claims. <\/p>\n \u201cWhen they\u2019re short paying us, that is just the opposite of what I would view competitive to be. They\u2019re not treating us fairly, and they\u2019re not paying us according to our contract,\u201d Carter said.<\/p>\n Carter said the extra work has strained Portneuf\u2019s administration. \u201cThe payment methods that they use \u2026 are administratively killing us because of the hassle that it is to go back and forth,\u201d he said.<\/p>\n Regence, however, claims its offers to increase payments were snubbed by Portneuf.<\/p>\n \u201cThey ultimately decided to walk away from a competitive multi-year offer,\u201d the Regence release states. \u201cOur proposed agreement offered Ardent Health rate increases that more than cover the cost of care for Regence patients.\u201d<\/p>\n Carter disputes that this offer was competitive.<\/p>\n \u201cRegence pays other Idaho-based hospitals and systems significantly more than they\u2019ve offered to pay us, which is the definition of not being competitive,\u201d Carter said.<\/p>\n Regence says this was not the outcome it hoped for and that its goal is still to provide members with \u201caccess to high-quality healthcare at an affordable price.\u201d <\/p>\n \u201cWe are disappointed in Ardent Health\u2019s response; however, we need to stand up for affordability for our employer group customers and members,\u201d the insurance company says.<\/p>\n Where can Regence policyholders go for care? <\/p>\n Portneuf says people who are insured through Regence will still be able to receive emergency care at in-network rates, but non-emergency services \u201cmay result in higher out-of-pocket costs.\u201d<\/p>\n The health care company\u2019s release also says that some patients may qualify for \u201ccontinuity of care protections,\u201d and that people should call 1-888-675-6570 for details, or the number on the back of their insurance card.<\/p>\n Regence says that some of its members may be eligible for continuity of care for a limited time, with eligibility conditions that include:<\/p>\n Seeing the provider for a serious or complex condition, including certain chronic conditions Undergoing a course of institutional or inpatient care from the provider Being scheduled for non-elective surgery from the provider Being pregnant and seeing the provider for pregnancy-related care Being determined to be terminally ill <\/p>\n Portneuf provides a full list of insurances accepted in its network at portneuf.org\/insurance<\/a>. It also says it has staff available to assist patients in transitioning their care to another provider, and that medical records can be found in MyChart, or by calling 208-239-1100 or at portneuf.org\/request-medical-records<\/a>.<\/p>\n Additionally, Regence provided a list of facilities in eastern Idaho, as well as some online providers, that are within its network.<\/p>\n Hospitals:<\/p>\n Bingham Memorial Hospital, Blackfoot, Idaho Caribou Medical Center, Soda Springs, Idaho Mountain View Hospital, Idaho Falls, Idaho Idaho Falls Community Hospital, Idaho Falls, Idaho Grove Creek Medical Center, Blackfoot, Idaho <\/p>\n Primary care and multispecialty clinics:<\/p>\n Bingham Memorial Clinics, Pocatello, Idaho MVH PIC (Physicians Immediate Care), Pocatello, Idaho Brandon A West Clinic, Pocatello, Idaho Health West, Chubbuck, Idaho Intermountain Medical Clinic, Pocatello, Idaho <\/p>\n Virtual providers:<\/p>\n Doctor on Demand<\/a> \u2013 on-demand access to medical and behavioral health providers Hinge Health<\/a> \u2013 virtual physical therapy AbleTo<\/a> \u2013 mental health therapy for ages 18+ Charlie Health<\/a> \u2013 behavioral health services for ages 11-34 Equip<\/a> \u2013 treatment for eating disorders for all ages Talkspace<\/a> \u2013 behavioral health counseling for ages 13+; psychiatry\/medication management for ages 18+ Boulder Care<\/a> \u2013 substance use disorder treatment Vynca<\/a> \u2013 palliative care NOCD<\/a> \u2013 treatment for obsessive-compulsive disorders for ages 6+ <\/p>\n When he spoke with EastIdahoNews.com, Carter took issue with Regence directing its members to some out-of-town facilities as alternative places to seek healthcare. <\/p>\n \u201cFrom somebody that lives here in this community \u2026 it would be a very big ask to say, \u2018Go find another provider in Idaho Falls,’\u201d he said. \u201cThat\u2019s not reasonable for people in Pocatello to drive to Idaho Falls for healthcare.\u201d<\/p>\n Working toward a deal <\/p>\n Both Portneuf Health and Regence BlueShield of Idaho maintain that negotiations are ongoing.<\/p>\n \u201cOf late, calls and counter proposal exchanges have occurred multiple times a day as both sides work toward resolution,\u201d Riepl said.<\/p>\n Carter also said that on Wednesday, the day of our interview, he had already had an hour-long phone call with Regence representatives and had another scheduled for later that day. <\/p>\n \u201cWe\u2019re still very much in the middle of it,\u201d Carter said.<\/p>\n When asked what Portneuf Health could do to make a deal possible, Riepl replied, \u201cWhen Idaho organizations work to understand each other\u2019s needs and pursue a middle ground, agreements naturally follow.\u201d<\/p>\n CORRECTION: An earlier version incorrectly identified Regence BlueShield of Idaho as Regence BlueCross of Idaho. <\/p>\n \t \t \t \t=htmlentities(get_the_title())?>%0D%0A%0D%0A=get_permalink()?>%0D%0A%0D%0A=htmlentities(‘For more stories like this one, be sure to visit https:\/\/www.eastidahonews.com\/ for all of the latest news, community events and more.’)?>&subject=Check%20out%20this%20story%20from%20EastIdahoNews” class=”fa-stack jDialog”> \t <\/p>\n","protected":false},"excerpt":{"rendered":"POCATELLO \u2013 When contract negotiations between Portneuf Health and Regence BlueShield of Idaho failed, allowing their existing agreement…\n","protected":false},"author":2,"featured_media":716011,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-716010","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/716010","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=716010"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/716010\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/716011"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=716010"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=716010"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=716010"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}